Glioblastoma virotherapy touted on CBS program is promising but preliminary.

A glioblastoma therapy touted in a "60 Minutes" report that aired Sunday evening, focusing on the use of the polio virus to treat glioblastoma, isn’t a particularly new idea and results are still unpublished -- but some oncologists are worried that patients might not have gotten that message from the program.

The segment highlighted an approach being tested by researchers at Duke University involving an engineered poliovirus that is aimed at inducing an immune attack on glioblastoma tumor cells.

Neuro-oncologist and team member Henry Friedman, MD, reported an increase in median survival of over 6 months. "So we've got patients that are out as far as 33, 34 months," he told 60 Minutes. "That is just unheard of in this disease."

Study leader and director of Preston Robert Tisch Brain Tumor Center Darell Bigner, MD, PhD, did not call the patients "cured." But he reported that four patients are "in remission" (defined as living longer than 6 months).

On the other hand, half of the 22 patients in the Duke trial have died.

Since the story aired, patients have been calling Duke from all over the country, officials at Duke told MedPage Today. The Brain Tumor Center has received hundreds of calls and more than 200 online inquiries.

Much Ado About Preliminary Findings

But is there too much hype made over preliminary results? Some leading oncologists think so.

In the early 1980s, the National Cancer Institute's Steven A. Rosenberg, MD, PhD, evaluated interferon and interleukin-2 (IL-2) to treat renal cell carcinoma and melanoma. The approach was nonspecific, frequently unsuccessful, and had a toxic side effect profile.

"It is premature to draw any conclusion but 'possibly interesting' from what was presented," Bruce Chabner, MD, director of clinical research and Massachusetts General Hospital and former director of the National Cancer Institute's Division of Cancer Treatment, told MedPage Today in an email.

It is unclear how well the preparation works, what mechanism it uses, and what a safe dose is, he added. "It is clearly far behind the new, approved immunotherapies (checkpoint inhibitors) in terms of being ready for marketing."

Chabner added, "I think it was a disservice to the cancer community (physicians and patients) to present this in such a superficial and premature way."

The "60 Minutes" report was "irresponsible journalism," Daniel Hayes, MD, clinical director of the Breast Oncology Program at the University of Michigan and president-elect of the American Society of Clinical Oncology (ASCO), told MedPage Today in an email.

"This is what's wrong with medical coverage by the press ... and cancer coverage specifically. Breathless hype over 'breakthroughs' before the scientific process has demonstrated that the new approach is or is not better than what we do," Hayes said.

"I hope the Duke investigators have really made progress; Lord knows we need better treatment for brain cancers. But this sort of hysterical report, raising false hope, does not further our cause," he added.

Though the oncolytic virotherapy that Duke researchers are looking at is promising, the immune-checkpoint blocking approaches are "much more exciting" at this point, Jason Luke, MD, a melanoma and advanced solid tumor specialist at the University of Chicago, told MedPage Today in an email.

"Particularly, preliminary clinical data in glioblastoma is quite exciting suggesting that the systemic administration of PD-1 blocking antibodies may have significant benefits for these patients," he said.

"In melanoma and lung cancer, drugs such as ipilimumab (anti-CTLA4), nivolumab (anti-PD1), and pembrolizumab (anti-PD1) are approved therapies and standards of care," he said. "Similarly, there are immune-checkpoint blocking antibodies approaching FDA approval in bladder and renal cancers. These approaches are also being evaluated in many other cancers with significant early success nearly across the board."

Strides in Virotherapy

Others expressed enthusiasm about the use of an oncolytic virus to target cancer.

"Duke used a very clever way to turn the immune system on to fight the cancer," Andrew Lassman, MD, a neuro-oncologist at NewYork-Presbyterian Hospital/Columbia University Medical Center in New York, told MedPage Today. "The power of the immune system has never really been tapped in this way before," he added.

"The presumption is that the immune system is triggered to respond to either the virus or the lysis of cancer cells," Ezra Cohen, MD, associate director for translational science at UC San Diego Moores Cancer Center, told MedPage Today in an email.

Though the idea is not novel, "efficacy of these agents is improving over time as we get better at engineering the viruses," he said.

It will be important to distinguish which patients benefited from the treatment and why, Lassman said. "We don't know which approach is right for which patient and whether combinations of immune therapies with more traditional approaches such as radiotherapy may be better than either approach alone."

Burke Brooks, MD, of the Ochsner Medical Center in Baton Rouge, LA, was optimistic about the trial results but cautioned that the treatment was not necessarily safe.

"The public needs to understand that this is research and listen carefully to Dr. Friedman's words about the patients that died from this treatment," he told MedPage Today in an email.

"I believe there is something to this and would encourage a patient to enter this exciting area of research," he added.

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